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Assessment of the Respiratory-Induced Kidney Motion Reproducibility by Fast Volumetric 4DMRI

O Wong , J Yuan , Y Zhou*, S Yu , K Cheung , Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong Island


(Sunday, 7/29/2018) 5:05 PM - 6:00 PM

Room: Room 202

Purpose: The internal organ motion is clinically assessed using 4DCT during radiotherapy treatment planning with the presumption of good respiratory-induced organ motion reproducibility. However, this presumption can often be violated by the irregular respiratory pattern as revealed by other surrogate or imaging studies. We aimed to evaluate the inter-(respiratory)-cycle and inter-subject reproducibility of the kidney motion using a fast volumetric 4D-MRI

Methods: Abdominal 4DMRI were axially acquired on 9 healthy subjects (34±6 years) using a CAIPIRINHA –accelerated 3D gradient echo VIBE sequence (voxel size = 2.7x2.7x4mm3, 56 slices, 1.63 volume/second, 144 volumes, free-breathing). Left(LK) and right kidneys(RK) were manually segmented on the chronologically 2nd volume (reference volume). The remaining volumes were rigidly registered to the reference volume to obtain the time-resolved volumetric kidney motion along superior-inferior(SI), anterior-posterior(AP) and left-right(LR) directions. For both kidneys, the motion range (∆r) was calculated in each respiratory cycle. The inter-subject reproducibility of kidney motion was evaluated with the coefficient of variation(CV) of the motion range of all subjects. For each subject, the inter-cycle variability was calculated by the ratio of the standard deviation of the motion range difference between respiratory cycles to the mean motion range.

Results: The smaller CVs (better inter-subject reproducibility) were obtained along SI (LK=0.26(CV), 10.0±2.7mm(∆r); RK=0.27(CV), 10.4±2.8mm(∆r)) than that along AP (LK=0.58(CV), 2.3±1.3mm(∆r); RK=0.54(CV), 4.2±2.2mm(∆r)). CV along LR was not reported because it had very small ∆r and, thus, was more susceptible to sources of uncertainty. The smallest inter-cycle reproducibility was observed along SI for both kidneys (LK=0.20±0.07; RK=0.18±0.06). Larger inter-cycle variability was observed in LK than RK in all directions (LK=0.20±0.07(SI), 0.48±0.43(AP); RK=0.18±0.06(SI), 0.27±0.10(AP)).

Conclusion: The inter-subject and inter-cycle reproducibility of the renal motion was <0.27 and <0.20, respectively for both kidney along SI direction. Our results might be useful in evaluating the treatment delivery efficiency in motion compensated radiotherapy.


Organ Motion, MRI


IM/TH- MRI in Radiation Therapy: MRI for treatment planning

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